Bell’s Palsy : Symptoms, Diagnosis and Management

Bell’s Palsy : Symptoms, Diagnosis and Management

Bell’s palsy is a form of facial paralysis resulting from a dysfunction of the cranial nerve VII (the facial nerve) causing temporary weakness of the muscles on one side of the face. Symptoms vary from person to person. It is of following types:

Partial palsy: That is mild muscle weakness
Complete palsy: There is no movement  at all (though very rare)

Symptoms :
  • Irritation of the affected eye, such as dryness or increased tear production
  • Pain underneath the ear on the affected side of the face
  • Drooling from the mouth on the affected side of the face
  • Dryness of the mouth
  • Difficulty in eating or drinking
  • Impaired speech
  • Weakness or paralysis in one side of the face, which may make it difficult to close the eyelid and cause the side of the mouth to droop
  • An altered or reduced sense of taste
  • Increased sensitivity to sound in the affected ear
  • Pain around the jaw
  • Headache
  • Dizziness


  • The herpes virus is common cause of inflammation of the facial nerve.
  • The herpes simplex virus (HSV), including either herpes type 1 (HSV-1) which causes cold sores or herpes type 2 (HSV-2) which causes genital herpes.
  • The varicella-zoster virus, which causes chickenpox and shingles.

Facial Nerve:

  • The facial nerve (VII) passes through a narrow gap of bone near the upper jaw on its way from the brain to the face. If the facial nerve is compressed or swollen it can interfere with the signals that brain sends to the muscles of the face.
  • This interference can restrict the blood and oxygen supply to nerve cells and cause the facial weakness or paralysis that is characteristic of Bell’s palsy.

There is no specific test to diagnose Bell’s palsy. Symptoms associated with the bell’s palsy help physician to determine the disease.

Magnetic resonance imaging (MRI): It is used to determine the cause of the pressure on facial nerve. MRI scans use radio waves and a strong magnetic field to produce a detailed image of the inside of body.

Computerized tomography (CT) scan: It is also be used to detect other causes of symptoms, such as an infection or tumor. A facial CT scan may also be carried out to rule out facial fractures.

Electromyography (EMG): It is a very thin needle electrode that is inserted through the skin into the muscle. A machine called an oscilloscope is then used to measure the electrical activity of the muscles and nerves. The information provided by an EMG can be used to assess the extent of any nerve damage.


Pain relievers: Paracetamol and NSAIDs (non-steroidal anti inflammatory drugs) such as ibuprofen etc. are effective pain killers.

Hot and cold treatment: Hot bath or a hot water bottle placed on the affected area helps ease the pain. Cold treatment such as an ice pack or a bag of frozen vegetables, placed on the painful area is also effective.

Relaxing: Trying to relax is a crucial part of easing the pain because muscle tension caused by worrying about condition can make things worse.

Medication: Corticosteroids like Prednisolone helps in reducing inflammation (swelling), which should also help to speed up your recovery.

Physiotherapy: Physiotherapist will teach facial exercises that help in strengthening the muscles in the face to improve their co-ordination and range of movement.